11D2040022 CLIA NUMBER - KROGER PHARMACY #699

Laboratory Demographics

  • CLIA Code: 11D2040022
  • Facility Name: KROGER PHARMACY #699
  • Facility Address: 3240 S COBB DRIVE
    SMYRNA, GA
    ZIP 30082
  • Facility Phone: 770 433-3420
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1518244482
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2040022
LAB Type Pharmacy
Facility Name KROGER PHARMACY #699
Street 3240 S COBB DRIVE
City SMYRNA
State GA
ZIP 30082
Phone 770 433-3420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Pharmacy
Lab Director CHUCK PAGE

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This page was last updated on: 9/29/2025